| 1. |
- Baylis, Rebecca, et al.
(författare)
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Women's experiences of internet-delivered Cognitive Behaviour Therapy (iCBT) for Fear of Birth
- 2020
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Ingår i: Women and Birth. - : ELSEVIER. - 1871-5192 .- 1878-1799. ; 33:3, s. E227-E233
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Tidskriftsartikel (refereegranskat)abstract
- Background: Fear of Birth is common in pregnant women and associated with negative physical and mental health. There is a clear comorbidity with anxiety and depression. Internet-delivered Cognitive Behaviour Therapy has been suggested as a treatment option for Fear of Birth and a randomized controlled trial comparing internet-delivered Cognitive Behaviour Therapy with midwifery led counselling as standard care has been conducted.Objective: The aim of this study was to describe women's experiences of guided internet-delivered Cognitive Behaviour Therapy for Fear of Birth and to describe the content of their fear.Methods: The present study is a qualitative, follow-up interview study following the randomized controlled trial, the U-CARE Pregnancy Trial. In total 19 women allocated to internet-delivered Cognitive Behaviour Therapy for Fear of Birth were interviewed by telephone. A semi-structured interview guide was used and the transcripts were analyzed with thematic analysis.Results: The women's descriptions of Fear of Birth differed, however their fear was most often associated with fear of losing control, fear for the baby's life or health or own life threatening events. The experiences of internet-delivered Cognitive Behaviour Therapy for Fear of Birth varied, some women were positive to its flexibility although most women preferred a face-to face meeting. The treatment did not pin-point their fears, it was challenging to maintain motivation and to work with the treatment in solitude.Conclusions: Women's descriptions of Fear of Birth varied. Most women undergoing internet-delivered Cognitive Behaviour Therapy would have preferred a face-to-face meeting which they imagined would have soothed their fear. Internet-delivered Cognitive Behaviour Therapy for Fear of Birth may be an alternative for some women.
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| 2. |
- Haines, Helen, et al.
(författare)
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Cross-cultural comparison of levels of childbirth-related fear in an Australian and Swedish sample
- 2011
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Ingår i: Midwifery. - : Elsevier BV. - 0266-6138 .- 1532-3099. ; 27:4, s. 560-567
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Tidskriftsartikel (refereegranskat)abstract
- Background: research, conducted predominately in Scandinavian countries, suggests that a substantial number of women experience high levels of fear concerning childbirth which can impact on birth outcomes, the mother-infant relationship and the ongoing mental health of the mother. The prevalence of childbirth-related fear (CBRF) is not well known outside of the Nordic nations. This study aimed to examine the prevalence of CBRF in two rural populations (Sweden and Australia) and to pilot a short, easy-to-administer measurement tool. Methods: a questionnaire assessing a range of childbirth-related issues was administered to women in the first trimester across two rural populations in Sweden (n=386) and Australia (n=123). CBRF was measured using the Fear of Birth Scale (FOBS) a two-item visual analogue scale. Findings: close to 30% of women from the Australian and Swedish samples reported elevated levels of CBRF in the first trimester. A previous negative birth experience and less than positive attitudes to their current pregnancy and birth were predictive of high levels of fear. Swedish women with high levels of fear indicated a preference for caesarean section as the mode of birth in this pregnancy. A higher proportion (19%) of Australian women indicated that they would prefer an elective caesarean section, compared with only 8.8% of the Swedish sample; however, this was not related to high levels of fear. Preference for caesarean section was related to CBRF in the Swedish sample but not in the Australian sample. Conclusion: the high proportion of women identified with CBRF suggests a need for monitoring of women during pregnancy, particularly those with a previous negative birth experience. The FOBS developed for this study could be used as a screening tool to identify women who require further investigation. Further cross-cultural research is needed to explore the role of fear in women's preference for caesarean section.
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| 3. |
- Haines, Helen, et al.
(författare)
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Identifying women who are afraid of giving birth : A comparison of the fear of birth scale with the WDEQ-A in a large Australian cohort
- 2015
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Ingår i: Sexual & Reproductive HealthCare. - : Elsevier BV. - 1877-5756 .- 1877-5764. ; 6:4, s. 204-210
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundThe WDEQ-A is the most widely used measure of childbirth fear in pregnant women; however there is increasing discussion in the literature that simpler, more culturally transferrable tools may offer a better solution to identifying fearful women in clinical practice.AimTo compare the two item Fear of Birth Scale (FOBS) with the 33 item WDEQ-A in a large cohort of Australian pregnant women.MethodSelf-report questionnaires during second trimester including Wijma Delivery Expectancy Questionnaire (WDEQ-A) and Fear of Birth Scale (FOBS). Correlation of FOBS and WDEQ-A was tested using Spearman's correlation coefficients. Receiver operating characteristic (ROC) curve assessed the sensitivity and specificity of possible cut-points on the FOBS against WDEQ-A cut-point of ≥85. Sensitivity, specificity, positive and negative predictive values were determined. Fearful and non-fearful women as classified by both instruments were compared for differences in demographic, psycho-social and obstetric characteristics.Results1410 women participated. The correlation between the instruments was strong (Spearman's Rho = 0.66, p < 0.001). The area under the ROC was 0.89 indicating high sensitivity with a FOBS cut-point of 54. Sensitivity was 89%, specificity 79% and Youden index 0.68. Positive predictive value was 85% and negative predictive value 79%. Both instruments identified high fear as significantly associated with first time mothers, previous emergency caesarean and women with self-reported anxiety and/or depression. Additionally FOBS identified a significant association between fearful women and preference for caesarean.ConclusionThis study supports the use of the FOBS in clinical practice to identify childbirth fear in pregnant women.
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| 4. |
- Haines, Helen M., et al.
(författare)
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The influence of women's fear, attitudes and beliefs of childbirth on mode and experience of birth
- 2012
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Ingår i: BMC Pregnancy and Childbirth. - : Springer Science and Business Media LLC. - 1471-2393 .- 1471-2393. ; 12, s. 55-
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Tidskriftsartikel (refereegranskat)abstract
- Background: Women's fears and attitudes to childbirth may influence the maternity care they receive and the outcomes of birth. This study aimed to develop profiles of women according to their attitudes regarding birth and their levels of childbirth related fear. The association of these profiles with mode and outcomes of birth was explored.Methods: Prospective longitudinal cohort design with self report questionnaires containing a set of attitudinal statements regarding birth (Birth Attitudes Profile Scale) and a fear of birth scale (FOBS). Pregnant women responded at 18-20 weeks gestation and two months after birth from a regional area of Sweden (n = 386) and a regional area of Australia (n = 123). Cluster analysis was used to identify a set of profiles. Odds ratios (95% CI) were calculated, comparing cluster membership for country of care, pregnancy characteristics, birth experience and outcomes.Results: Three clusters were identified - 'Self determiners' (clear attitudes about birth including seeing it as a natural process and no childbirth fear), 'Take it as it comes' (no fear of birth and low levels of agreement with any of the attitude statements) and 'Fearful' (afraid of birth, with concerns for the personal impact of birth including pain and control, safety concerns and low levels of agreement with attitudes relating to women's freedom of choice or birth as a natural process). At 18 - 20 weeks gestation, when compared to the 'Self determiners', women in the 'Fearful' cluster were more likely to: prefer a caesarean (OR = 3.3 CI: 1.6-6.8), hold less than positive feelings about being pregnant (OR = 3.6 CI: 1.4-9.0), report less than positive feelings about the approaching birth (OR = 7.2 CI: 4.4-12.0) and less than positive feelings about the first weeks with a newborn (OR = 2.0 CI 1.2-3.6). At two months post partum the 'Fearful' cluster had a greater likelihood of having had an elective caesarean (OR = 5.4 CI 2.1-14.2); they were more likely to have had an epidural if they laboured (OR = 1.9 CI 1.1-3.2) and to experience their labour pain as more intense than women in the other clusters. The 'Fearful' cluster were more likely to report a negative experience of birth (OR = 1.7 CI 1.02-2.9). The 'Take it as it comes' cluster had a higher likelihood of an elective caesarean (OR 3.0 CI 1.1-8.0).Conclusions: In this study three clusters of women were identified. Belonging to the 'Fearful' cluster had a negative effect on women's emotional health during pregnancy and increased the likelihood of a negative birth experience. Both women in the 'Take it as it comes' and the 'Fearful' cluster had higher odds of having an elective caesarean compared to women in the 'Self determiners'. Understanding women's attitudes and level of fear may help midwives and doctors to tailor their interactions with women.
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| 5. |
- Haines, Helen, 1961-, et al.
(författare)
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The Role of Women's Attitudinal Profiles in Satisfaction with the Quality of their Antenatal and Intrapartum Care
- 2013
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Ingår i: Journal of Obstetric, Gynecologic and Neonatal Nursing. - : Elsevier BV. - 0884-2175 .- 1552-6909. ; 42:4, s. 428-441
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Tidskriftsartikel (refereegranskat)abstract
- Objective To compare perceptions of antenatal and intrapartum care in women categorized into three profiles based on attitudes and fear. Design Prospective longitudinal cohort study using self-report questionnaires. Profiles were constructed from responses to the Birth Attitudes Profile Scale and the Fear of Birth Scale at pregnancy weeks 18 to 20. Perception of the quality of care was measured using the Quality from Patient's Perspective index at 34 to 36 weeks pregnancy and 2 months after birth. Setting Two hospitals in Sweden and Australia. Participants Five hundred and five (505) pregnant women from one hospital in Vasternorrland, Sweden (n=386) and one in northeast Victoria, Australia (n=123). Results Women were categorized into three profiles: self-determiners, take it as it comes, and fearful. The self-determiners reported the best outcomes, whereas the fearful were most likely to perceive deficient care. Antenatally the fearful were more likely to indicate deficiencies in medical care, emotional care, support received from nurse-midwives or doctors and nurse-midwives'/doctors' understanding of the woman's situation. They also reported deficiencies in two aspects of intrapartum care: support during birth and control during birth. Conclusions Attitudinal profiling of women during pregnancy may assist clinicians to deliver the style and content of antenatal and intrapartum care to match what women value and need. An awareness of a woman's fear of birth provides an opportunity to offer comprehensive emotional support with the aim of promoting a positive birth experience.
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| 6. |
- Hildingsson, Ingegerd, et al.
(författare)
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A known midwife can make a difference for women with fear of childbirth- birth outcome and women's experiences of intrapartum care
- 2019
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Ingår i: Sexual & Reproductive HealthCare. - : Elsevier BV. - 1877-5756 .- 1877-5764. ; 21, s. 33-38
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Tidskriftsartikel (refereegranskat)abstract
- Background: There is evidence that continuity of midwifery care is beneficial to women. Women with fear of childbirth in Sweden are offered counselling, but receiving care from a known midwife during labour is unusual, despite its effects in reducing interventions and increasing birth satisfaction. The aim of this study was to describe and compare birth outcome and experience of intrapartum care among women with fear of childbirth who received intrapartum care from a known midwife, versus those who did not. Methods: An experimental study of 70 women referred to counselling due to fear of birth during pregnancy wherein the counselling midwife, when possible, also assisted during labour and birth. Results: Having a known midwife during labour and birth had a positive impact on fearful women's birth experience and their perception of pain, but there was no difference in onset of labour or mode of birth. Women who received care from a known midwife experienced better care with regards to information, participation in decision making and perception of control. Conclusion: This study indicates that having access to a known midwife might have an impact on women's birth experience. This study was limited by its small sample size and further research would need to randomise fearful women to counselling or continuity of care to determine the contribution of each to reducing fear.
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| 7. |
- Hildingsson, Ingegerd, 1955-, et al.
(författare)
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Caseload midwifery for women with fear of birth is a feasible option
- 2018
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Ingår i: Sexual & Reproductive HealthCare. - : ELSEVIER IRELAND LTD. - 1877-5756 .- 1877-5764. ; 16, s. 50-55
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Continuity with a known midwife might benefit women with fear of birth, but is rare in Sweden. The aim was to test a modified caseload midwifery model of care to provide continuity of caregiver to women with fear of birth. Methods: A feasibility study where women received antenatal and intrapartum care from a known midwife who focused on women's fear during all antenatal visits. The study was performed in one antenatal clinic in central Sweden and one university hospital labor ward. Data was collected with questionnaires in mid and late pregnancy and two months after birth. The main outcome was fear of childbirth. Result Eight out of ten women received all antenatal and intrapartum care from a known midwife. The majority had a normal vaginal birth with non-pharmacological pain relief. Satisfaction was high and most women reported that their fear of birth alleviated or disappeared. Conclusion: Offering a modified caseload midwifery model of care seems to be a feasible option for women with elevated levels of childbirth fear as well as for midwives working in antenatal clinics as it reduces fear of childbirth for most women. Women were satisfied with the model of care and with the care provided.
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| 8. |
- Hildingsson, Ingegerd, et al.
(författare)
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Childbirth fear in expectant fathers : findings from a regional Swedish cohort study.
- 2014
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Ingår i: Midwifery. - : Elsevier BV. - 0266-6138 .- 1532-3099. ; 30:2, s. 242-247
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE:to investigate the prevalence of childbirth related fear in Swedish fathers and associated factors.DESIGN:a regional cohort study. Data was collected by a questionnaire.SETTING:three hospitals in the middle-north part of Sweden PARTICIPANTS: 1047 expectant fathers recruited in mid-pregnancy during one year (2007) who completed the Fear of Birth Scale (FOBS).MEASUREMENTS:prevalence of childbirth fear and associated factors. Crude and adjusted odds ratios were calculated between men who scored 50 and above (childbirth fear) and those that did not (no fear). Logistic regression analysis was used to assess which factors contributed most to childbirth fear in fathers.FINDINGS:the prevalence of childbirth fear in men was 13.6%. Factors associated with childbirth related fear were as follows: Less positive feelings about the approaching birth (OR 3.4; 2.2-5.2), country of birth other than Sweden (OR 2.8; 1.3-6.1), a preference for a caesarean birth (OR 2.1; 1.7-4.1), childbirth thoughts in mid-pregnancy (OR 1.9; 1.1-2.0) and expecting the first baby (OR 1.8; 1.2-2.6).KEY CONCLUSIONS:high levels of fear were associated with first time fathers and being a non-native to Sweden. Men with fear were more likely to experience pregnancy and the coming birth as a negative event. These men were also more likely to identify caesarean section as their preferred mode of birth.IMPLICATIONS FOR PRACTICE:engaging expectant fathers in antenatal conversations about their experiences of pregnancy and feelings about birth provides health-care professionals with an opportunity to address childbirth fear, share relevant information and promote birth as a normal but significant life event.
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| 9. |
- Hildingsson, Ingegerd, et al.
(författare)
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Childbirth fear in Swedish fathers is associated with parental stress as well as poor physical and mental health
- 2014
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Ingår i: Midwifery. - : Elsevier BV. - 0266-6138 .- 1532-3099. ; 30:2, s. 248-254
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Tidskriftsartikel (refereegranskat)abstract
- Objective: to compare self-rated health and perceived difficulties during pregnancy as well as antenatal attendance, birth experience and parental stress in fathers with and without childbirth related fear. Design: a longitudinal regional survey. Data were collected by three questionnaires. Setting: three hospitals in the middle-north part of Sweden. Participants: 1047 expectant fathers recruited in mid-pregnancy and followed up at two months and one year after birth. Measurements: childbirth fear was assessed using the Fear of Birth Scale (FOBS). Self-rated physical and mental health and perceived difficulties were assessed in mid pregnancy. Two months after birth antenatal attendance, mode of birth and the birth experience were investigated. Parental stress was measured using the Swedish Parental Stress Questionnaire (SPSQ). Crude and adjusted odds ratios were calculated between expectant fathers who scored 50 and above (childbirth fear) and those that did not (no fear). Findings: expectant fathers with childbirth related fear (13.6%) reported poorer physical (OR 1.8; 95% CI 1.2-2.8) and mental (OR 3.0; 1.8-5.1) health than their non-fearful counterparts. The fearful fathers were more likely to perceive difficulties in pregnancy (OR 2.1; 1.4-3.0), and the forthcoming birth (OR 4.3; 2.9-6.3) compared to fathers without childbirth fear. First-time fathers with fear attended fewer antenatal classes. Fathers with high fear reported higher mean scores in four of the five subscales of the SPSQ. Childbirth related fear was not associated with mode of birth or fathers' birth experience. Key conclusions: expectant fathers with childbirth related fear had poorer health, viewed the pregnancy, birth and the forthcoming parenthood with more difficulties. They were less often present during antenatal classes and had higher parental stress. Implications for practice: this study provides insight into the health of expectant fathers during pregnancy and highlights the importance of understanding how childbirth fear may affect expectant fathers in both the short and longer term. © 2013 Elsevier Ltd.
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| 10. |
- Hildingsson, Ingegerd, 1955-, et al.
(författare)
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Exploring the Fear of Birth Scale in a mixed population of women of childbearing age : A Swedish pilot study
- 2018
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Ingår i: Women and Birth. - : Elsevier BV. - 1871-5192 .- 1878-1799. ; 31:5, s. 407-413
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Tidskriftsartikel (refereegranskat)abstract
- Aim: The aim of this pilot study was to explore the Fear of Birth Scale in a mixed sample of women of childbearing age, by investigating the levels of childbirth fear and the content of women's thoughts when completing the scale. Methods: A cross-sectional mixed method study of 179 women who completed a short questionnaire and a think aloud interview. Results: The mean score of the Fear of Birth Scale was 40.80 (SD 27.59) and 28.5% were classified as having fear of childbirth (>= 60). The internal consistency showed a Cronbach's alpha > 0.92, and a mean inter-item correlation of 0.85. The highest scores were found in women younger than 25 years (mean 60.10), foreignborn women (mean 54.30) and women who did not have any previous children (48.72). The lowest scores were found in women who had recently given birth (mean 34.82) and women older than 35 years (mean 34.85). The content analysis categorization matrix clearly accommodated all 436 statements into the five pre-existing categories. The largest categories were: the content of fear and worry with 138 statements and strategies to cope with fear or worry (122 statements). Conclusion: The Fear of Birth Scale seems to be a useful instrument for different subgroups of women. The construct of fear of childbirth may be universally understood and experienced by women of childbearing age irrespective of whether they are currently pregnant, have recently given birth or do not have children. Identifying fear of birth is important in clinical practice in order to support women's reproductive needs.
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